Carbohydrates and Diabetes

Chapter 4
 Carbs have been vilified and
misunderstood!
• Don’t eat that, it has too many carbs!

• Carbs make us fat!

• Pasta, potatoes, rice…forbidden foods!

• Sugar makes kids hyper!

 Carbohydrates in our diet are mostly from plants.
Photosynthesis is the process by which green plants
create carbohydrates using the energy from sunlight.
 What are carbohydrates?

Your body uses carbohydrates (carbs) to make

glucose which is the fuel that gives you energy
and helps keep everything going.

Your body can use glucose immediately or store

it in your liver and muscles for when it is
needed. The storage form is called glycogen.
What Happens
to Carbohydrates
in Your Body?
Carbohydrates come mainly from plant foods,
they can be found in these foods:
• Fruits
• Vegetables
• Breads, cereals, and other grains
• Milk and milk products
• Sugar-sweetened beverages
• Foods containing added sugars (e.g., cakes, cookies,
crackers, snack foods).
The one exception is dairy foods.
 Functions of Carbohydrates
• Provide energy
• Spare proteins
• Supply fiber:
– Provide a feeling of fullness
– Contribute to digestive tract health
– Support normal bowel function
– Lower blood cholesterol
– Slow absorption of sugar
• Two main types of carbs: simple & complex
Simple carbohydrates contain a single sugar unit or two
sugar units combined. These are mono- and
disaccharides.
Complex carbohydrates contain many sugar units
combined. These are called polysaccharides.

3 types:
Starch
Glycogen
Fiber
Starch is stored in plants in the form of thousands of
glucose units strung together in a chain.

Pasta, rice, bread, and potatoes are all excellent sources of starch.
Fiber is the part of a plant that we eat but cannot
digest . Humans lack the ability to digest fiber.
Most foods contain both types of fiber and some fibers
can have multiple health effects in your body.
 Simple Carbohydrates
~Added Sugars
~Naturally Occurring Sugars
 Naturally occuring sugars are found in foods such as
fruit and dairy products. These tend to be more
nutrient-dense and provide more nutrition.

food.gather.com
Added sugar foods are sugars that manufacturers add
to foods such as soda and candy, sweets. (“empty
calories”)
 Dietary Guidelines for Americans, 2015

• Reduce the intake of calories from solid fats and

<10% calories from added sugars
• Limit the consumption of foods that contain refined
grains, especially refined grain foods that contain
solid fats, added sugars, and sodium.
• Consume at least half of all grains as whole grains.
Increase whole-grain intake by replacing refined
grains with whole grains.
Ways to Decrease Sugar in your Diet:
•Drink less sugar-sweetened
beverages.
•Limit consumption of baked
goods and desserts that are
high in sugar.
•Read labels carefully to choose
foods that are lower in added
sugar.
•Choose canned fruit that is
packed in water or juice
instead of heavy syrup.
 Complex Carbohydrates

• Two types: starch and dietary fiber

• Starch must be broken down through digestion
before your body can use it as a glucose source.
• Starch is in certain vegetables (i.e., potatoes, dry
beans, peas, and corn).
• Starch is also found in breads, cereals, and grains.
• Dietary fiber is in vegetables, fruits, and whole grain
foods.
 Ways to Increase Fiber in Your Diet
• Choose oatmeal or whole-grain cereals for breakfast
Eat two pieces of whole fruit daily as snacks
• Use brown rice instead of white rice
• Choose bread made from 100% whole grain
• Choose unbuttered popcorn as a low-fat snack
• Layer lettuce, tomatoes, other veggies on your
sandwich
• Substitute whole-grain flour for all-purpose flour in
recipes
• Eat a small salad with dinner nightly or once a day
We should limit consumption of refined grains,
especially those that contain solid fats, added sugars,
and sodium.

Choose more whole grains!

How many of you feel confident that you can identify
a whole grain food?
 Whole grains or foods made from them contain all the
essential parts and naturally-occurring nutrients of the
entire grain seed.

http://www.wholegrainscouncil.org/
Good Sources of
Whole Grains:

Brown rice
Oatmeal
Popcorn
Barley
Whole-grain oats
Whole-grain rye
Whole wheat
quinoa

Try a new grain!

With the Whole Grain Stamp, finding three servings of
whole grains is easy: Pick three foods with the 100%
Stamp or six foods with ANY Whole Grain Stamp.

BUT WHAT IF THERE IS NO STAMP?

Words you may see on packages What they mean

•whole grain [name of grain] YES -- Contains all parts of the grain, so you're getting all
•whole wheat the nutrients of the whole grain.
•whole [other grain]
•stoneground whole [grain]
•brown rice
•oats, oatmeal (including old-fashioned
oatmeal, instant oatmeal)
•wheatberries

•wheat, or wheat flour MAYBE -- These words are accurate descriptions of the
•semolina package contents, but because some parts of the grain
•durum wheat MAY be missing, you are likely missing the benefits of
•organic flour whole grains. When in doubt, don't trust these words!
•stoneground
•multigrain (may describe several whole
grains or several refined grains, or a mix of
both)

•enriched flour NO -- These words never describe whole grains.

•degerminated (on corn meal)
•bran
•wheat germ
FRONT
BACK

LOOK FOR THIS INSTEAD

A product must deliver at least 16 grams
of whole grain to be considered 1 serving
Carbohydrate Guidelines:

• Complex carbohydrates are our best source of dietary fiber

and starch.

• Whole fruits and vegetables, whole grains, legumes, and low

fat dairy products are our best sources of carbohydrates.

• 45-65% % of the calories in our diet should come from

carbohydrates.

• consume 25-38 grams/day of fiber.

• consume <10% of our daily calories from added sugars.

 What’s the Bottom Line??
• Read labels carefully when shopping for whole-grain
products, including bread, crackers, cereals, and pasta.

• Choose products that clearly state “100% whole grain”

or “100% whole wheat” on the package.

• The second best options are products that list “whole-

wheat flour” or another whole-grain ingredient as the
first ingredient, NOT enriched flour. (Heads up: Oats
and brown rice are automatically whole-grain, even if
they’re not preceded by the word “whole”.)
Ready to Make a Change?

I commit to a small first step

Switch the bread you usually consume to one that is
whole grain

I am ready to take the next step and make a medium

change
Choose oatmeal at least twice a week for breakfast

I have been making changes for some time and am

ready for a large change in my overall health
Make at least half of your grains whole.
 Weight of the Nation: Obesity and Type 2
Diabetes Facts
• Diabetes is the seventh leading cause of death in the United
States.
• Nearly 26 million Americans have diabetes; of that, 7 million
are undiagnosed.
• Obesity, weight gain, sedentary lifestyles and family history
are all risk factors for type 2 diabetes.
• Type 2 diabetes can be delayed or prevented by losing a
modest amount of weight.
• The Diabetes Prevention Program. Has shown that lifestyle
changes can reduce the risk of diabetes by 58%, twice the
reduction achieved with medication alone.
 Discussion
• Did you know how diabetes affects our bodies before
watching the film?
• Were you surprised to learn that simple behavior
changes—losing a small amount of weight and making
physical activity a part of your life—can delay or prevent
the onset of type 2 diabetes?
• Given that even modest lifestyle changes can reduce our
risk of developing type 2 diabetes, why do you think the
rates of diabetes are increasing so rapidly in the United
States?
• What barriers are preventing us from curbing the
diabetes epidemic of type 2 diabetes?
There are two important hormones that regulate blood
glucose levels: insulin and glucagon.
Response to eating Response to lack of
a meal food.
Diabetes is a disease in which the body cannot regulate
blood glucose levels normally due to a lack of insulin, or
insulin resistance.
In type 1 diabetes the body’s immune system destroys
cells in the pancreas that produce insulin.
Type 2 diabetes begins with insulin resistance, in which
the pancreas produces insulin, but the cells do not
respond to the insulin.
The primary risk factor for development of type 2
diabetes is being overweight or obese.

Incidence of type 2 diabetes has increased rapidly

and is similar to the increases seen in obesity.
 Age-Adjusted Prevalence of Obesity and Diagnosed
Diabetes Among U.S. Adults Aged 18 Years or older

Obesity (BMI ≥30 kg/m2)

1994 2000 2010

No Data <14.0% 14.0-17.9% 18.0-21.9% 22.0-25.9%

>26.0%
Diabetes
1994 2000 2010

No Data <4.5% 4.5-5.9% 6.0-7.4% 7.5-8.9% >9.0%

CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at

http://www.cdc.gov/diabetes/statistics
Uncontrolled diabetes is associated with a
number of serious long-term consequences.
• Heart disease and stroke
• High blood pressure-75% of people with DM have HBP
• Blindness—DM is #1 cause
• Kidney Damage—damage to small vessels leads to
kidney failure
• Nerve damage—can result in poor circulation, damage
and impaired sensation in hands and feet
• Amputation—poor circulation can lead to tissue
death.
You can lower risk of developing diabetes by
maintaining a healthy body weight, diet changes and
regular physical activity.

Lose weight—5-7% of former body weight

Exercise 2 ½ hours per week

Eat a plant-based, heart healthy diet (high

fiber)